LACEY MAE RIVERA NPI 1790607497

NPI Information

  • NPI: 1790607497
  • Provider Name: LACEY MAE RIVERA
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 473 W ASPEN PEAK DR
    SOUTH JORDAN, UT
    ZIP 84095
  • Phone: (801) 694-6979

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NPI Details

Lacey Mae Rivera is a family nurse practitioner in South Jordan, UT. Lacey Mae Rivera NPI is 1790607497. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

473 W ASPEN PEAK DR
SOUTH JORDAN, UT
ZIP 84095-129
Phone: (801) 694-6979

The enumeration date for this NPI number is 7/27/2026 and was last updated on 7/27/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily13002591-4405UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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